Tan ASH, Saafan TSM, Ashoush F, Mahawar K. What bariatric surgery can teach us about glucagon-like peptide-1 agonist weight loss therapy: Improving long-term outcomes and patient care. World J Clin Cases 2026; 14(20): 121701 [DOI: 10.12998/wjcc.121701]
Corresponding Author of This Article
Tamer Saafan Moustafa Saafan, FRCS, Upper GI Surgery, South Tyneside and Sunderland NHS Foundation Trust, Harton Ln, Sunderland SR4 7TP, United Kingdom. tsaafan@gmail.com
Research Domain of This Article
Surgery
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review-article
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Tan ASH, Saafan TSM, Ashoush F, Mahawar K. What bariatric surgery can teach us about glucagon-like peptide-1 agonist weight loss therapy: Improving long-term outcomes and patient care. World J Clin Cases 2026; 14(20): 121701 [DOI: 10.12998/wjcc.121701]
Arianna Sze Huey Tan, Tamer Saafan Moustafa Saafan, Kamal Mahawar, Upper GI Surgery, South Tyneside and Sunderland NHS Foundation Trust, Sunderland SR4 7TP, United Kingdom
Fouad Ashoush, Upper GI Surgery, Northumbria Healthcare NHS Foundation Trust, Cramlington NE23 6NZ, Northumberland, United Kingdom
Co-first authors: Arianna Sze Huey Tan and Tamer Saafan Moustafa Saafan.
Author contributions: Mahawar K formulated the concept of this review; Tan ASH, Saafan TSM, and Mahawar K performed editing and reviewing the literature; Tan ASH and Saafan TSM performed methodology searching; Tan ASH, Saafan TSM, and Ashoush F completed the literature search and review. All authors prepared the draft and approved the submitted version. Tan ASH and Saafan TSM contributed equally to the manuscript.
AI contribution statement: AI tools (specifically ChatGPT) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Corresponding author: Tamer Saafan Moustafa Saafan, FRCS, Upper GI Surgery, South Tyneside and Sunderland NHS Foundation Trust, Harton Ln, Sunderland SR4 7TP, United Kingdom. tsaafan@gmail.com
Received: March 31, 2026 Revised: May 10, 2026 Accepted: June 12, 2026 Published online: July 16, 2026 Processing time: 100 Days and 22 Hours
Abstract
The use of anti-obesity medications (AOMs) is rising rapidly. However, structured monitoring and support for these patients remain limited. In contrast, bariatric surgery has well-established multidisciplinary care models that address nutritional requirements, psychological screening, and long-term risk management. Bariatric surgery pathways could inform safer and more comprehensive care for individuals on glucagon-like peptide-1 receptor agonists (GLP-1RA). A literature search was conducted on MEDLINE and EMBASE Ovid, focusing on short- and long-term outcomes of bariatric surgery and pharmacological weight-loss therapies. Bariatric surgery pathways routinely incorporate nutritional monitoring and supplementation, reflecting the well-recognised risks of protein and micronutrient deficiencies. Comparable guidance for pharmacotherapy is lacking, despite similar risks. Rapid weight loss is associated with gallstone formation, with evidence supporting ursodeoxycholic acid prophylaxis in surgical patients, but evidence is lacking in pharmacotherapy Surgical care further emphasises lean mass preservation, dietary counselling, and psychological support, which are inconsistently addressed in GLP-1RA users. The growing use of AOMs highlights the need for more comprehensive care frameworks. Adopting key elements of established bariatric surgery pathways may enhance safety, improve patient education, and optimise long-term outcomes for individuals receiving AOMs.
Core Tip: Obesity is a prevalent chronic disease associated with significant metabolic and psychosocial morbidity. While metabolic bariatric surgery (MBS) remains the most effective treatment, incretin-based therapies, particularly glucagon-like peptide-1 receptor agonists, are increasingly used. However, these agents are relatively new, with limited long-term data and risks related to rapid weight loss, including nutritional deficiencies, lean mass loss, and psychosocial effects-well recognised in bariatric practice. Unlike MBS, which benefits from structured follow-up and multidisciplinary care, pharmacotherapy pathways often lack equivalent monitoring and support. This review explores how bariatric principles can improve the safety and long-term outcomes of anti-obesity medication use.
